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OB/Community Health > Prenatal Education & Infertility > Flashcards

Prenatal Education & Infertility Flashcards

1
Q

What is the overall goal of prenatal education ?

A

empowerment so that the patient can make a informed decision about their pregnancy

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2
Q

How do we empower the woman in her pregnancy ?

A
  • give options for safe delivery of care
  • recognize that the patient has a right to evidence-based, accurate and complete information
  • recognize that the patient’s choice may align with their cultural and personal values and preferences
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3
Q

What does Early Pregnancy education look like ?

A

knowing the expected changes your body goes through
- fetal development
- physiological/emotional changes
- sexuality
- nutrition

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4
Q

What does Mid Pregnancy education look like ?

A

prepping the patients for parenting
- breastfeeding
- infant health and care
- safe sleep methods
- parenting
- changing diapers

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5
Q

What does Late Pregnancy education look like ?

A

preparing for delivery and the birthing process
- coping with labor and birth
- touring the location where you may be giving birth

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6
Q

What is considered a low-risk pregnancy ?

A

pregnancy with no previous or current maternal or fetal implications

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7
Q

What is a doula ?

A

a person who offers support during labor and postpartum
- can be certified
- usage has shown to reduce use of analgesics, shorten labor, increase satisfaction with delivery, increase breastfeeding, increase likelihood of spontaneous vaginal delivery

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8
Q

What is a Certified Nurse Midwife ?

A

has a Nursing background and a advanced degree
- Masters in midwifery

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9
Q

What is a Direct-Entry Midwife ?

A

is credentialed but got this without a Nursing background
- has formal education and is certified

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10
Q

What is a Traditional/Lay Midwife ?

A

not certified by instead trained by self-study or apprenticeship

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11
Q

What is a birth plan ?

A

a tool in which parents can explore childbirth options and develop a “plan” for the day
- helps communicate preferences to healthcare team
- can give pt’s a sense of control and responsibility

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12
Q

What are some considerations with a birth plan ?

A
  • should be fluid and flexible
  • verify with healthcare providers before delivery starts to ensure they are all in agreement
  • nurses discuss lots of these options at admission
  • mobility
  • fetal monitoring
  • surroundings
  • partner participation
  • episiotomy, forceps or vacuum
  • IV
  • C/section
  • bonding
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13
Q

What is the purpose of childbirth preparation classes ?

A

prepare and practice coping mechanisms for labor pain experience

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14
Q

What are the 6 core principles of Lamaze ?

A
  1. labor begins on its own
  2. freedom of movement is crucial
  3. importance of continued labor support
  4. avoid non-medically necessary interventions
  5. non supine position for delivery
  6. no separation of mom and baby after birth for unlimited breastfeeding opportunities
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15
Q

What is the Dick-Read technique ?

A

focuses on the fear, tension and pain cycle
- says that fear causes tension which then increases pain
- comes from “childbirth without fear” book from UK physician

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16
Q

What is the Gaskin maneuver ?

A

it frees the baby’s shoulder when its stuck behind the mom’s pelvic bone

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17
Q

What is the Gaskin technique ?

A

its a low intervention technique to reduce fear during delivery
- have a calm environment and encourage mom with certain words when afraid

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18
Q

What does the Lamaze technique promote ?

A

an unmedicated no intervention birth and a positive bonding experience with baby
- control of pain through breathing techniques
- most well known

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19
Q

What is the Bradley technique ?

A

similar to Lamaze but has a reinforced coach at the bed-side
- used to be known as the husband coach childbirth
- used to be innovative but now questionable because it gives power to the husband/coach over the person giving birth

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20
Q

What is the LeBoyer technique ?

A

infant focused waterbirth
- it focuses more on the newborn experience
- quiet room with dim lighting
- water transition after birth
- good option for low risk moms

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21
Q

What is Hypnobirthing ?

A

a self-hypnosis technique that helps reduce fear of delivery with women
- you train the brain to achieve deep relaxation
- involves positive affirmations, and takes practice
- pt’s are still fully aware and participate in birthing process

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22
Q

Why may someone choose placental consumption ?

A

says it helps prevent postpartum depression and bleeding
- increases mom’s milk supply and helps patient get back iron that was lost during delivery
- usually placenta is packaged into capsules that are consumed

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23
Q

What is a gentle c-section ?

A

this is more about the experience
- there is a clear drape so the pt can see more of what is happening during the procedure
- skin to skin in OR
- play music and delayed cord clamping

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24
Q

Why may delayed 1st bath be chosen ?

A

shown to increase breastfeeding and decrease hypothermia and hypoglycemia
- wait at least 8 hrs or even longer

25
Q

What is delayed cord clamping ?

A

lets baby get the most blood from the placenta and cord for as long as possible
- wait about 30-60 secs before cutting
- can be down with term and preterm baby’s
- increases the iron levels

26
Q

What is a Lotus Birth ?

A

leaving placenta attached until the umbilical cord falls off naturally
- INFECTION RISK and not lots of data to support this
- says it can increase blood and nourishment to the baby
- less invasive transition from womb to external world
- can be a ritual to honor shared life from baby and placenta

27
Q

What is vaginal seeding ?

A

using cotton swabs or balls that have vaginal fluid on them and placing that on baby’s mouth, nose or skin
- still being studied
- helps replicate the microbiome that baby’s go through during vaginal births for C-section baby’s
- evidence that it decreases chances of asthma, immune disorders and entopic disease

28
Q

What is the definition of infertility ?

A

couples who haven’t been able to get pregnant:
- after 1 year of regular unprotected intercourse when the woman is less then 35 yrs of age
- or after 6 months when the woman is over the age of 35

29
Q

Why does the definition of infertility change based on the woman’s age ?

A

fertility naturally decreases as you go over the age of 35 yrs old

30
Q

Before the age of 35, what is the chance of getting pregnant each month ?

A

25-30%

31
Q

What percentage of couples get pregnant within 6 months ?

A

80%
- this is why you wait the 6 months before you take extra steps

32
Q

What is the difference between primary and secondary infertility ?

A
  • Primary: pt has never been pregnant before
  • Secondary: pt has been pregnant before
33
Q

What are some risk factors for female infertility ?

A
  • Hx of STDs: can cause scar tissue and this can impair fallopian tube uptake
  • certain meds can cause infertility
  • genetics
    • Turner’s syndrome: only 1 chromosome
    • PCOS: ovary fails to release eggs regularly (hormonal)
  • smoking & drinking
  • over the age of 35 yrs
  • irregular periods: hard to track ovulation cycle
  • any uterine disorder that causes scar tissue
  • past cancers
  • obesity
34
Q

What are some risk factors of male infertility ?

A
  • congenital disorders
  • nutrional deficiencies
  • obesity
  • substance abuse & smoking
  • endocrine disorders (diabetes)
  • Hypospadias: urethra opening is on the underside instead of tip of penis
  • Varicoceles: enlarged veins in the testicles that can impair sperm count and motility
  • STIs
  • environmental toxins: pesticides, lead, radiation
  • medications: some anti-hypertensives
35
Q

What are the most common issue that cause male infertility ?

A

hormone and sperm transport issues

36
Q

What is the first step in fertility testing ?

A

a thorough history and physical, lab work, and semen analysis
- least to most invasive

37
Q

What is the purpose of a pelvic ultrasound in fertility testing ?

A

looking for abnormal uterine anatomy

38
Q

In the female blood work, what levels may we look at for fertility testing ?

A
  • estrogen
  • progesterone
  • follicle stimulating hormone (FSH)
39
Q

In the male blood work, what levels may we look at for fertility testing ?

A
  • testosterone
  • follicle stimulating hormone (FSH)
  • gonadotropin
40
Q

In semen analysis testing for fertility, what do they look at ?

A

sperm count, shape and motility

41
Q

What are the female testing methods for fertility ?

A
  • hormone testing (blood work)
  • pelvic ultrasound
  • hysteroscopy
  • hysterosalpingography
42
Q

What is the purpose of a hysteroscopy in fertility testing ?

A

inserting a camera into the uterus to look at the health of the uterus
- looking for abnormalities

43
Q

What is the purpose of a hysterosalpingography in fertility testing ?

A

usage of X-ray to look at the uterus and fallopian tubes for blockages or abnormalities
- you fill up the uterine space with a dye which then creates a outline of the uterus and fallopian tubes that can be seen through a X-ray to be examined

44
Q

What are the male testing methods for fertility ?

A
  • semen analysis
  • physical exam
  • homone test (blood work)
45
Q

What are some medical therapy methods to treat fertility ?

A
  • Clomid
  • Hormones: progesterone, gonadotropins & FSH supplements
  • metformin
46
Q

How does Clomid help in fertility ?

A

helps stimulate ovarian function and ovulation
- common 1st line med for couple that has tried for 6 months or 1 yr
- increases risk of multi-fetal pregnancy (especially twins or triplets)

47
Q

How does Metformin help in fertility ?

A

helps induce ovulation by reducing the insulin resistance
- good option for pt’s with PCOS (polycystic ovarian syndrome)

48
Q

What is IVF ?

A

invitro fertilization
- collect eggs and sperm then you fertilizes the 2 in a lab which creates a embryo which can be transferred into the uterus
- “test tube” baby
- very expensive
- can be from 12,000-20,000 (average is 15,000) and not typically covered by insurance

49
Q

What is IUI ?

A

intrauterine insemination
- you place quality sperm into the uterus at the time of ovulation
- good option for men with low sperm count and motility
- much cheaper then IVF
- about 1,000

50
Q

What is the difference between a surrogate mother and gestation carrier ?

A
  • Gestation Carrier: has no genetic link with the fetus
  • Surrogate Mother: shares genetic link with the baby and gets paid to do this (have to had at least 1 previous successful pregnancy)
51
Q

What is preimplantation genetic diagnosis ?

A

taking an embryo and doing testing to identify any genetic disorders

52
Q

Why is embryo storage so controversial ?

A

what happens to the extra embryo’s you don’t use
- ethical dilemma
- do you donate to another person or to research ?

53
Q

What is selective reduction ?

A

when you implant multiple embryo’s to see how many take and then chose from those which to keep
- Ex.) you implant 6 and then all 6 take so now you have 6 embryo’s but that is a high risk pregnancy so you choose which embryo’s to keep
- want to avoid complications

54
Q

What are some risk for having multiple fetuses in 1 pregnancy ?

A
  • preterm labor
  • postpartum hemorrhage
  • preterm delivery
  • baby’s can end up in NICU (costly)
55
Q

What is Endometriosis ?

A

where the tissue that normally lines the uterus (endometrium) appears in locations where it shouldn’t
- typically found around the reproductive organs
- causes legions to form which can lead to scar tissue which can lead to infertility

56
Q

Why can scar tissue lead to miscarriage ?

A

placentas don’t like to grow where there is scar tissue so there is an increased risk for miscarriage

57
Q

What are some S&S of Endometriosis ?

A

inflammatory response:
- pelvic pain
- dysmenorrhea (painful periods or cramps)
- painful intercourse

58
Q

What are some treatment options for Endometriosis ?

A
  • NSAIDS during menstruation (for mild symptoms)
  • oral contraceptives (low dose): can be take for a long period of time and help prevent tissue forming outside the uterus, make periods shorter, and reduce inflammation
  • GnRH agonist: can medically induced menopause which can help suppress the endometrial lesion formation
  • laparoscopy: removal of lesions if you have more severe symptoms (can still get pregnant)
  • TAH (total abdominal hysterectomy): for pt’s that don’t want to get pregnant and if symptoms are bad

OB/Community Health (12 decks)

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